Provider Demographics
NPI:1154865475
Name:LAIR, SHARON (MA)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:LAIR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 CALDERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-2285
Mailing Address - Country:US
Mailing Address - Phone:318-625-7571
Mailing Address - Fax:318-445-7977
Practice Address - Street 1:1715 ASHLEY AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-7344
Practice Address - Country:US
Practice Address - Phone:318-625-7571
Practice Address - Fax:318-445-7977
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-05
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health